I gained a lot of weight during the time I was on chemo for leukemia. It’s been very hard to get rid of it, as I’m also perimenopausal, and limited physically as far as what activity I can safely do. Add a history of eating disorders, and the idea of losing weight is actually rather frightening at times. I guess in some ways that’s good, since I don’t take for granted how bad things got the last time I relapsed in 1995-1996. It took years to put my life back together so I could eat with some degree of ‘normal’ now and then, and longer than that before I could accept my body without being disgusted by it. My oncologist told me just to be thankful I’m alive (which I am), and don’t focus so much on the weight. Easier said than done.
The last time I started to relapse coincided with being diagnosed as diabetic, and suddenly having to account for everything that passed by my lips. I lost about 50 pounds over several months prior to, and after being diagnosed (not noticeably abnormal ), and was holding my own without any eating disorder behaviors (purging- laxatives were my vice, restricting, excessive exercise, etc). I ended up with pneumonia later that year (November 1995), and lost quite a bit of weight in a few days, and the sensation of being ’empty’ and seeing the scale numbers drop was enough to trigger the old eating disorder stuff that started when I was in my late teens and twenties (early 80s). I’d been free of the ‘active’ anorexic end of things for many, many years, though the war in my head was never silent. It didn’t take long for being around food to cause anxiety, and for numbers on the scale, calorie books, and blood sugar meters to drive my entire life. I lost another 50 pounds in about three months. Other people noticed.
I worked at a drug and alcohol treatment center as a detox RN (and weekend charge nurse of sorts- if anything was wacky on campus, I had the last word if it was OK or not, though with serious stuff, I had plenty of folks to call for feedback and input) , so my coworkers were very aware of what addictive behavior looked like. And denial. And refusal to listen to rational feedback. I coasted for a bit, but by the time a formal intervention was done, I was in bad shape. Eating anything was excruciating. Every night, I was asking God to just let me wake up in the morning. And I literally crawled up the stairs to and inside my apartment. Chunks of skin fell off of my heels. Things weren’t good.
The day of the intervention was on the day after having worked a double shift. I got off at 7 a.m. and went to rest for a while in one of the cabins my coworker had (she lived a few counties away and stayed on campus when she worked- we worked weekends and Mondays) while she went to do some discharge summaries, which I planned to do as well once I got some rest. She came and got me at around noon, and asked me to come with her to get something to drink, and also drop off something in the Operations Director’s office.
I never saw it coming. Inside the Operations Director’s office were my boss, her husband (who also worked there with the clinical staff), the medical director, day charge nurse, and several other people, including clinical staff who I worked with as well. There were 8-10 people there. When I saw them all in the office, I knew what was going on. I was terrified, but also wanted to stop fighting the wars in my head over something as ‘stupid’ as food. It’s never about food, but that was what was going on mentally. I was told of the plan to take me directly to my apartment to pack (supervised), then driven to the San Antonio International Airport to be put on a plane. Someone would take care of my dog (that’s a whole different story), and my car could stay on campus where it could be safe. I’d fly to Houston, where an outreach employee would meet me, and be sure I got on the flight to Los Angeles. That was the only way I’d be allowed to come back to work. What I hadn’t told them was that my primary doc had told me that I probably wouldn’t last a month, tops, if I continued as I was. Their timing was perfect. I wouldn’t have been ready before then. And it was still hard to say “yes”, but also a sort of relief. Until I got there.
So, off to Los Angeles I went. Scared to death… I knew they made people EAT in eating disorder treatment. But, I figured the sooner I got with the program, the sooner I’d get out of there. So, in a feeble way, I’d begun to surrender on the plane. By the time I got there, I was so exhausted from the double shift, then the intervention, traveling, etc, that the guy who picked me up thought I’d OD’d on something that made me semi-coherent. I was just flat-out tired, and told him I was there for not eating (I never looked like I was starving as much as I was). I was also exhausted from the battle fatigue from what had been going on in my head for months. I’d been ‘confronted’ a couple of weeks earlier by a former coworker from another place I worked, about my weight (she was dropping off her child for treatment), and she asked if there was anything wrong with me. I didn’t know how to answer. It didn’t register that losing fifty pounds would be visible to anyone. Seriously. That jarred me a bit, but the intervention had the biggest impact.
I went to the treatment center in California (they no longer ‘do’ eating disorder treatment, thank God), and it was horrible. The facilities were pleasant, and the food was good (which amazed me, since I didn’t like much of anything, but all of the fresh produce ALL THE TIME was great) ! A few of the staff were decent, but eating disorder treatment it was not. And the primary ‘assigned’ therapist I had was bad news… I was not allowed to speak about some things that seemed therapy-worthy to me. The ED patients had a table segregated from other patients in the dining room (and we were often like an exhibit in a zoo for the other patients who wanted to see if we ate), and one OA meeting a week (otherwise we went to AA). That was the ED program. They may have been great for chemical dependency and/or dual diagnosis, but I was a generic eating disorder NOS (not otherwise specified) patient. They didn’t get that right either. They labelled me bulimic; I didn’t binge.
When I first got there, I was so weak that when I went on the ‘beach walk’, I could barely make it. Walking in the sand was exhausting, and I was having a lot of trouble even keeping a visual on the rest of the bunch who opted to do that activity. My jeans were falling off, so they gave me a trash bag to tie two belt loops together, then trimmed the excess so it didn’t violate the safety rules about plastic bags.
The day before I was sent there, I’d packed up a detox patient to go there for more dual diagnosis issues than we generally dealt with at our facility, and then I showed up as a patient. Surprised her ! We sort of stuck like glue together, trying to make sense of the place. Then another patient, AND person who worked where I worked showed up… They were both dumbfounded about the detox and treatment process (so had a lot of questions), but come to find out one hadn’t told them all of the things she’d been taking. I told her she needed to fess up for her own safety. They’d come to me (their former nurse) before talking to the staff there. I wasn’t licensed in CA, and I was off the clock out there- but I was glad to be of some support. We all needed each other out there.
There were a few of us ED patients, and we stuck together between groups, wondering where the ED services in the brochure were. But, I managed to survive 36 days out there. The last 11 days, I had a virus of some sort, and wasn’t allowed to participate in any groups or meetings (but wasn’t sent home). They’d taken me to an ER, where they had me pee in a cup, and then decided I had a BLOOD virus- from a pee test… The group would literally come to my room at the end of the session to say hello. I could go outside and sit in the sun (or smoke), but no activities anyone else was doing. I could go to the dining room with everyone else, so it wasn’t like they were worried about me giving bugs to someone… but whatever. I’d huddle by the dryer vents to smoke in the morning when it was so much cooler outside. I had a few roommates, some ED and one alcoholic, (at different times) who were nice enough. But I left there feeling totally unprepared for going home and making it OK. I had no aftercare. I was more scared leaving than when I got there.
One really funny thing happened one evening, during my ‘banishment’ from groups, when I was outside smoking. One of the techs (fondly called the ‘clipboard jockeys’) came running around the corner asking if I’d seen the REST OF THE PATIENTS. All of them ! 😮 I told him no, and he was sure I must know something, even though I wasn’t allowed in groups. I really didn’t know. Come to find out that the rest of the patients were doing the evening community group, and after the tech checked everybody off of his clipboard, they went to another room to mess with him, and hide. Eventually, all showed up, and the tech laughed, but I can imagine the thoughts going through his head about how he’d lost the entire lot of patients, except the puny one not allowed to go to groups. That would have been a serious pile of incident reports and phone calls.
In the meantime I’d been told that I would NOT be allowed back to work where I’d been working at the time of the intervention until the director of nurses OK’d it (she had some serious boundary issues, and was also a neighbor of mine who had been in contact with my therapist in the treatment center- acting like some sort of information verifier. The treatment center wouldn’t let me talk about being raped until my boss had reported to them that it had actually happened when she found the info and news clippings in my apartment when I was gone). Anyway, I really liked that job, so that was a huge loss until I showed I was doing well enough to come back. Eventually, I did get to go back, and stayed another couple of years until things started feeling unsafe with a huge increase in census, and no changes in detox/nursing staffing for several months. But I’ll always be incredibly thankful that I got to work in that facility. I learned a lot, and am a better nurse for my experiences there. I’m still in contact with one person I worked with there.
The intervention likely saved my butt, even though I had a lot of work to do ON MY OWN when I got back. I got every professional book on EDs I could find, and did an ‘as if’ thing. I looked at what I needed to do ‘as if’ I were carrying out orders for one of my patients. I had to detach for a while. (The one OA meeting/group in town was ‘lead’ by someone who brought specific diets to show to the group- nothing 12-step about it, so I passed). Interventions are terrifying, but there was also a huge sense of relief at not having to go it alone any longer. When I got home, it was alone again.
For those who think it might happen to them, just go with it. Let everybody talk, and then be thankful that you don’t have to get well by yourself, and it doesn’t have to be perfect. One step at a time, even if they’re baby steps. But standard treatment centers just don’t ‘get it’. It has nothing to do with food, but the war in the person’s head about not being ‘worth’ food. ‘The voice’ makes the rules, and is tyrannical with internal dialogue.